The Copay Mystique

[Crabcake Johnny]

Here's what I'd like to hear:

When your prospect asks "Ok, so what will I pay when I see a doctor?"

The reply is......

I'd actually like to hear what Somarco says after that question is asked. I might find out why 95% of his book is HSAs.

 

[dmiller90]

So dmiller - what is your approach to a sale when someone wants to lower their outlay?

I'm curious to see how you would rebut Somarco if you followed him on a lead call?

Give it to me baby . . .

Tom

First Did not know people have outlays? when it comes to Health Insurance,

That questions does not even deserve an answer, But to answer you, Listen to your Client and quit pushing your believes and Bad information about Discounts and Negotiated savings, One day it will Burn Him, You are giving Clients information you cannot control or really have any idea of the Cost.

Not your Baby either.

 

[Expat]

Here's what I'd like to hear:

When your prospect asks "Ok, so what will I pay when I see a doctor?"

The reply is......

I'd actually like to hear what Somarco says after that question is asked. I might find out why 95% of his book is HSAs.

The correct response is: Whatever he charges.

 

[Crabcake Johnny]

True - and I will inform my client of the possible range in charges - which is the honest way to present HSAs.

Some agents, however, will explain-away the cost per visit with "well, after the re-pricing it should be "X" amount."

Some carrier's copay plans include in-office testing at the copay. In those cases a $2,000 office charge could be $30 or $40.

But it doesn't have to be that high for HSA clients to complaint. I've received none-too-happy calls when clients received $300 or $400 office bills.

That's when I ditched telling my clients that there's any "average" charge and simply was upfront - hence I'd never be able to sell anywhere close to 95% HSAs.

 

[somarco]

No, Ed, I do not use HSA comparison tools. Haven't found any I like.

Dave, I don't sell. I educate and inform, then let my client decide. They love to buy but hate to be sold.

Selling in GA? Come on big boy. I will whip your butt.

assuming the Aetna contract lowers doc visits to 60?

Assuming nothing, Ned.

I can show them the Aetna figures for many docs in Atlanta. Some are less than $50.

some families just can't get comfotable with the HDHP, regardless of the savings.

And I have a few as well. Most end up with $5k copay plans.

That's the other 5% or so of my client base.

so what will I pay when I see a doctor?"

The reply is......

I can't tell them . . . any more than I can tell them how much to diagnose and fix their car.

Then I ask how much their copay is for brakes, oil changes, tune ups, etc.

I just had gutters put on my house. Would have been nice to have a gutter copay.

But I don't . . .

Insurance is risk management. Either you, and your client understand that or they don't.

The ones that do buy HDHP plans every day and love it.

Although I do not subscribe to this theory, it is like buying term health insurance and investing the difference . . .

The correct response is: Whatever he charges.

Not exactly.

It is whatever the negotiated rate is.

I can show them pricing for Aetna and KP. The other carriers aren't up to speed on transparency but their negotiated pricing is similar.

I'd never be able to sell anywhere close to 95% HSAs

As is true of most agents.

Of course not all are HSA's. In fact, I never even mention the HSA until they are ready to jettison the copay for a higher deductible plan without copays. Many have Plan 100, Plan 80, Monogram. The rest are HSA qualified.

 

[Crabcake Johnny]

Can't sell Plan 100 or 80 here - $3,000 drug cap - can't buy it up.

 

[InsuranceBenefitsGroup]

The somarco example is a good one for folks already on meds. If they're clean with no meds, you're fighting an uphill battle going thru the HSA if they've never heard of one. In the past when I suggested them, my prospect would say "why the hell am I going to put extra $ towards my health insurance?" I would explain all of the advantages and they'd kinda get it but still want those copays. Then I'd ask myself what I'm doing making this sale more difficult than needed. With HSA's you're also pushing commisionable dollars towards the contribution for which agents are not paid. This is not a matter of ethics, just a matter of opinion -the same opinion you use when suggesting any plan to a prospect.

 

[somarco]

I never even mention the HSA until they are ready to jettison the copay for a higher deductible plan without copays.

Talking about funding a bank account in conjunction with buying insurance is too much to get their mind around. So I never use the word HSA, nor do I talk about the HSA side, until they like the idea of saving premium dollars that would otherwise go to the carrier.

Going back to the example above, I ask the client this.

Of the $640 you are paying to GR, how much of that is refunded at the end of the year?

The answer of course is $0.

So I then point out they won't get a refund on the $480 premium to Aetna for the copay plan. That money is gone and he will never see it again.

Same for the $380 for the HDHP 3000.

On the 3 plans viewed, he has a stack of cancelled checks for $640, $480 or $380.

Which would you rather have?

The answer was obvious . . . and we never even talked about the HSA. All he did was make a judgement call on risk dollars.

Earlier I told him what I tell all my clients.

The money you pay to the carrier is theirs to keep. They don't send you a refund. They don't send flowers or a thank you card. All they send is your premium increase at renewal.

I see no reason to pay for something you won't need.

The plan suggested below, in guy talk, (and I use this one too) is a Chevy with AM radio and crank windows. Absolutely nothing wrong with the plan. It just doesn't have all the bells & whistles.

I give them a choice of buying any of the plans discussed, including keeping their current plan and making me AOR.

Then I tell them something they don't expect.

I make less money on the lower premium plan than on the higher ones. But I also tell them they get the same level of service from me on the low premium plan as on the higher premium plans.

Most of the time they go for the lower premium.

Many times (I can't say most but I wish I could) they will refer friends to me . . . and most of the time they buy.

By giving away commissions on lower premium plans I actually earn more through referrals.

A guy I helped last year bought a Monogram for $82 per month. Since then, he has referred 9 people to me . . . only 8 of them bought . . . so far . . .

That situation is unusual, but a referral a month from one source is pretty amazing.

 

[myinsurebiz]

oh D - why so mean spirited pal?

" First Did not know people have outlays? when it comes to Health Insurance, "

Sure they do. They have to "lay out cash" for the premium, any co-pays, co-insurance, deductibles, etc - but it's ok - I'll use simpler words for you next time baby . . .

" That questions does not even deserve an answer "

Yes - please don't next time - your's made no sense anyway.

Somarco for President!

Tom

 

[Invain15]

I like the presentation. Very well written. I still believe in only selling what I believe the customer truly needs.